Could regular aspirin use reduce ovarian cancer risk?
The possible benefits of aspirin use as a way of preventing and treating cancer have been talked about for many years
There have been a number of studies on aspirin use as a way of preventing and treating ovarian cancer that have produced promising results. We take a look at a recent the study from the Ovarian Cancer Association Consortium (OCAC) and its implications.
What was the study?
This study expands on the evidence base to explore whether those who have an increased genetic risk of ovarian cancer also could benefit from aspirin in reducing their cancer risk.
What were the results?
The OCAC study looked at frequent aspirin use and the association of ovarian cancer risk amongst 4,476 case patients and 6,659 control participants. The results suggest that using aspirin as a chemoprevention program could target individuals at high-risk of ovarian cancer regardless of whether they have inherited genetic faults.
What does this mean?
The possible benefits of aspirin use as a way of preventing and treating cancer have been talked about for many years. A 2018 study showed one dose of aspirin leads to a 10% reduction in ovarian cancer risk and that a low dose of aspirin can improve chances of survival by up to 30% in women who have been diagnosed with ovarian cancer.
In 2012 a culmination of five studies showed a possible reduction of cancer spreading either at the point it was diagnosed, or later on. A further analysis of studies in 2014 suggested a potential risk reduction in bowel, oesophageal and stomach cancers.
However, there are still a lot of important questions that need answering before guidelines and recommendations can be made about aspirin as a way of preventing and treating ovarian cancer.
Cary Wakefield, CEO at Ovarian Cancer Action"Preventing cancer means we save lives. This study adds to growing evidence that aspirin is a promising ovarian cancer prevention tool for women with and without an increased genetic risk. These results now must be explored by clinicians so that women at high risk can benefit from these discoveries as soon as possible. Until then, taking aspirin regularly can have risks so it’s important that patients consider discuss its use for cancer prevention with medical professionals."
What else do we need to know?
Firstly, it needs to be established what the optimum dose of aspirin is to have a protective and/or preventative effect, and how long it needs to be taken for it to have this effect.
It is also important to establish the risks and benefits of taking aspirin as a risk reduction measure. Cancer Research UK predicts that for every 1,000 people who use aspirin for this reason 17 cases of cancer and heart attacks could be prevented. However, there could also be 2 or three people who die from a stroke or ulcer bleed as a result of increased and prolonged aspirin consumption. So there is a possible risk of exposing people who may never have developed any form of cancer in their life to other serious health conditions as a result of taking aspirin for a prolonged period of time.
Along with the risks that could be attributed to the long-term increased use of aspirin it is important to consider that it can cause complications in people who have things such as asthma, haemophilia and stomach ulcers. It can also increase the risk of internal bleeding, which some patients with cancer may already be at risk of due to the treatment they are having.
It is also important to establish at what age it would be most effective to start taking aspirin as a risk-reducing measure. Cancer Research UK suggests that the age bracket that would benefit most from prolonged aspirin use would be 50-70. We know that the majority of ovarian cancer cases are seen in women over the age of 50, so establishing more reliable information about this would be hugely beneficial when thinking about ovarian cancer risk.
For full answers to these questions much more research is required in the form of randomised control studies that take place over a number of years. Prospective monitoring of peoples aspirin intake, (including dosage, the duration it's taken for and the age at which people begin taking it), and then observing trends in cancer diagnosis and survival over a number of years would provide more reliable results, and allow guidelines to be established around how best to use aspirin.
What should I do?
If you are considering using aspirin to help reduce your risk of getting ovarian cancer, or as part of your treatment if you already have the disease we strongly advise that you discuss this with your GP or oncologist first. Despite the promising research, there are still many things that need to be established with certainty before it can be considered a safe and effective option.
Is there anything I can do about ovarian cancer risk?
There are a number of things that we know can affect a woman’s risk of getting ovarian cancer. These include family history and genetics, age, lifestyle and menstrual history.
We know that 20% of ovarian cancers are due to a genetic fault. Our Hereditary Cancer Hub includes all the information your need to know about genetic faults and ovarian cancer risk. Use our Hereditary Cancer Risk Tool to assess your risk of having inherited either the BRCA gene fault or Lynch syndrome based your family history. On completing the assessment, if it suggests that you may be at risk, you will be able to take your results to your GP for further discussion.